The career goal of Dr. Guadalupe Palos is to establish herself as an independent investigator in cancer control and behavioral science, with a focus on underserved and minority populations. The candidate's career plan offers an excellent opportunity to combine her previous training in oncology nursing and community social work with her academic preparation in health service research and behavioral science. The revised research plan has been greatly simplified and is designed to build upon an NIH-funded longitudinal study of symptoms in patients with advanced lung cancer (Principal Investigator, CS Cleeland, PhD). The study includes underserved minority and non-minority patients who will receive treatment in an inner city county hospital. This is an excellent opportunity to study the caregivers of ethnic minorities, who, because of their socioeconomic status, may be highly stressed or overwhelmed compared to other caregivers of cancer patients. [unreadable] [unreadable] This application integrates mentoring, training, and focused research to meet 3 objectives: a) to become an established investigator in the integration of qualitative and quantitative approaches in cancer control and behavioral science; 2) to use these multi-methods approaches to study the problems of caregivers and the patients they care for; and 3) to evaluate the effects of sociocultural factors on the caregiver's experience. Dr. Palos' exceptional mentor team consists of Charles S. Cleeland, PhD, Richard Payne, MD., Marjorie Kagawa-Singer, PhD, and Amalie Ramirez, PhD. Dr. Cleeland will provide mentorship in research related to measurement of symptoms. Dr. Payne, world-renown for his work in disparities and pain management will provide mentorship in these areas. Dr. Singer will be a mentor in the conceptualization and measurement of culture and ethnicity. Dr. Ramirez will mentor the candidate in developing culturally competent cancer communication for future caregiver interventions. Formal agreements and specific roles of the mentoring team have been documented and included. The research training will take place at MD Anderson Cancer Center/Lyndon Baines Hospital, and to a lesser extent at University of California (Dr. Kagawa-Singer), Hispanic Center of Excellence - San Antonio (Dr. Amelie G. Ramirez), and Duke University -Durham, NC (Dr. Payne). [unreadable] [unreadable] Research examining the negative outcomes in underserved minority caregivers, such as depression, stress, anxiety, pain, fatigue, or sleep disturbances, would help advance our understanding of these problems. This project has a longitudinal, descriptive design to evaluate these areas. The specific aims will be to (1) describe the meaning of the experience of being a minority (African-American or Latino) and non-minority person caring for a patient with advanced lung cancer; (2) describe and compare the experiences of minority and non-minority caregivers including the prevalence and severity of physical/psychological symptoms and their influence on caregiver symptom burden; and (3) assess the relationship between caregiver's symptoms (physical and psychological) and patient's symptom's at multiple time points over the course of the patient's treatment. The findings from this project will provide information from a sociocultural perspective that can be used to develop culturally competent interventions that can help reduce caregiver burden and improve their health outcomes. [unreadable] [unreadable] [unreadable]